Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 3759 | MN |
NPI | 1114060878 |
---|---|
Provider Name | Dr. Matthew Edward Collins |
First Address | Saint Paul, MN 55119-4323 |
Second Address | Saint Paul, MN 55119-4323 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 05/05/2015 |